Measuring and monitoring lean body mass in critical illness

Abstract

Purpose of reviewTo help guide metabolic support in critical care, an understanding of patients’ nutritional status and risk is important. Several methods to monitor lean body mass are increasingly used in the ICU and knowledge about their advantages and limitations is essential.Recent findingsComputed tomography scan analysis, musculoskeletal ultrasound, and bioelectrical impedance analysis are emerging as powerful clinical tools to monitor lean body mass during ICU stay. Accuracy, expertise, ease of use at the bedside, and costs are important factors which play a role in determining which method is most suitable. Exciting new research provides an insight into not only quantitative measurements, but also qualitative measurements of lean body mass, such as infiltration of adipose tissue and intramuscular glycogen storage.SummaryMethods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients at high nutritional risk and to evaluate metabolic support during critical illness.

The Change of Urea to Creatinine Ratio is Associated With Postoperative Complications and Skeletal Muscle Wasting in Pancreatic Cancer Patients Underwent Pancreatoduodenectomy

“…But sarcopenic or obese patients may also have normal BMI. Therefore, body composition analysis is increasingly gained attention in nutritional assessment and risk strati cation [29]. Martin et al demonstrated skeletal muscle depletion was a powerful prognostic factor, independent of BMI in cancer patients [30].…”

“…Meanwhile, the higher UCR in patients with CDC ≥ 3 in two weeks after surgery also support this assumption. Indeed, other than CT scan, several methods can be used to quantify the change of skeletal muscle mass [29]. Repeated ultrasonography shows promising results in detecting muscle wasting in several studies [47,48].…”

Skeletal Muscle Depletion and Nutrition Support Affected Postoperative Complications in Patients Underwent Pancreatoduodenectomy

“…In critical patients, muscle wasting was prevalent and profound. Up to 60-70% critical patients had muscle wasting at ICU admission [20], and 20% of skeletal muscle reduction was found in ICU patients within rst 10 days [21]. Both the quantity and quality of skeletal muscle affected the course and outcome of the disease [2,3].…”

Ultrasound imaging for measuring muscle and subcutaneous fat tissue thickness of the anterior thigh: A two-year longitudinal study in middle age

“…The technique has been used to monitor lean mass loss at the bedside in critically ill patients who experience quadriceps and skeletal muscle atrophy at a very early stage especially critically ill children . Clinicians can utilize objective data from US imaging to administer an appropriate metabolic support to improve muscle morphology and subsequently function . The authors believe that monitoring both muscle and subcutaneous thickness to assess their relative contributions is important.…”

“…28 Clinicians can utilize objective data from US imaging to administer an appropriate metabolic support to improve muscle morphology and subsequently function. 14,16,29 The authors believe that monitoring both muscle and subcutaneous thickness to assess their relative contributions is important.…”